Expanded care, non-bundled and bundled provided veterans enrolled in VA health care with services not often covered by Medicare.
The Department of Veterans Affairs (VA) has seen an increase over the last two years with veterans using skilled home health care. Skilled home health care is for veterans, who are enrolled in VA health care system, that need short-term care as they move from a hospital or nursing home back to their home, as well as continuing care due to ongoing needs. These skilled services include case management, skilled nursing, physical therapy, occupational therapy, speech therapy, wound care, medication management and more.
For more information about VA skilled home health care, please visit here.
There are three components of VA’s skilled home health care benefit that many veterans and their caregivers may not be familiar with – bundled, non-bundled and expanded care. Dan Schoeps, director of Purchased Long Term Services for the VA, explained the three types.
Expanded care – also known as private duty nursing – helps veterans who need care for an extended period of time. An example is a veteran who is ventilator dependent. The expanded care benefit would provide skilled nursing services to maintain the veteran at home and enable his or her caregiver the ability to leave the home for personal time.
Non-bundled authorizes skilled home care not typically covered under Medicare. This includes nursing, PT, OT, speech therapy, nutritional services, social worker services, home health aide, mental health and palliative skilled services. Examples would be non-progressing wound care where a nurse comes in every day or a couple of times a week to change the dressing, or a nurse helping a veteran manage their medication by refilling pill boxes. “(Medication management) is something Medicare used to cover but it doesn’t anymore,” Schoeps said. “But we (at the VA) still believe that people get in trouble with their medications – they don’t take them, they take the wrong ones, they take them at the wrong times. We still see value sending a nurse out. It keeps people out of hospitals, we are quite convinced.”
Bundled provides veterans with skilled home health care (OT, speech pathology, social worker and limited bath aide) following a period of hospitalization. This is like Medicare’s home health care benefit, Schoeps said. Bundle also authorizes homemaker/home health aide care not covered by Medicare. Over 85% of veterans use Bundled.
Under the three components, there is a copay for skilled home health care for Category 7 and Category 8 veterans, Schoeps added. There is no copay for Medicare in skilled home health.
To learn more about VA’s skilled home health care benefit coverage, read this reference guide.
- Veterans Healthcare